Good News: Understanding Eczema to Treat It

Published by:

Summer is both a blessing and curse for millions of people afflicted with a common chronic skin condition called eczema. The dry, red and usually intolerably itchy patches often recede when the air is warm and damp and skin is exposed more often to sunlight.

Yet, for many of the 15 million Americans with eczema, shedding the clothes may be embarrassing and, in the case of children, may result in teasing and exclusion. Even for those who are comfortable in a bathing suit, swimming in a pool can be problematic if sensitivity to chlorine worsens the condition.

In industrialized countries, eczema has become two or three times more common in recent decades. Only part of this rise can be attributed to better diagnosis. Now between 15 and 30 percent of children and 2 percent to 10 percent of adults have eczema, which nearly always begins in the first five years of life. Fortunately, in more than two-thirds of children with eczema, the condition resolves on its own beforeadolescence.

The medical name for eczema is atopic dermatitis, which reflects the immunological nature of the condition. It is more common among children living in cities than those in rural areas. According to the so-called hygiene hypothesis, exposure to infectious agents early in life offers protection against allergic diseases. The more hygienic a child’s environment, the greater the risk.

Eczema is not contagious, but more than one member of a family may be afflicted. The condition seems to have a genetic component. In identical twins, 77 percent will both have eczema, but it occurs in both fraternal twins only 15 percent of the time. My sons, who are identical twins, had eczema as young children, and one still has it in his 40s.

Another indication is the fact that people with celiac disease (a gluten intolerance) are three times more likely to have eczema; relatives of celiac patients are twice as likely to have eczema.

Eczema is often called “the itch you can’t scratch,” though a wiser description would be “the itch you shouldn’t scratch.” Scratching can make the lesions worse and expose the skin to infection.

“Scratching the spot when it’s itchy brings relief only as long as you scratch it,” said my son, Lorin. “After scratching, the itch generally stays the same or worsens. It’s better not to scratch, though sometimes the itch is so intense that scratching feels compulsory.”

Although there is no known cure for eczema, flare-ups can nearly always be minimized and sometimes prevented, and recent research has identified factors involved in its development that may lead to new treatments to control it more effectively.

Normal skin provides a remarkably effective physical and chemical barrier to substances in the environment. It also prevents substances that should remain in the body from escaping.

As Dr. Thomas Bieber, a dermatologist at the University of Bonn in Germany, explained in The New England Journal of Medicine, the hallmark of eczema is an alteration in the skin that allows essential water to escape and environmental allergens (like those from pollen, dust mites and food) to enter. The result is dry, itchy, inflamed patches that are sometimes misdiagnosed as psoriasis.

Eczematous skin also lacks normal amounts of a natural antimicrobial agent called cathelicidin, leaving it susceptible to infections that can be hard to control. More than 90 percent of people with eczema have colonies of the bacterium Staphylococcus aureus growing on their skin and contributing to the skin’s allergic sensitivity and inflammation, Dr. Bieber reported. Scratching the lesions enhances the ability of these bacteria to further disrupt the skin’s barrier function.

While it has long been known that the skin’s outermost layer functions poorly in people with eczema, researchers at the University of Rochester have identified another reason eczematous skin is susceptible to invasion by allergens. Dr. Anna De Benedetto and co-authors showed that a protective protein called claudin-1 is significantly weakened in the skin of eczema patients but not in those with normal skin or other skin conditions.

When claudin-1 is reduced, the “tight junctions” between skin cells become leaky and permeable to environmental allergens and infectious agents. If future studies confirm these findings, developing treatments that strengthen this barrier should improve control of eczema.

Current treatment focuses on reducing inflammation, loss of moisture and colonization by bacteria. Doctors typically recommend a prescription steroid, used topically in tiny amounts, coupled with an over-the-counter moisturizer applied generously right after showering to hold water in the skin. Only mild, nondrying bath soaps should be used.

Overly expensive and exotic skin products are not necessary, according to Dr. Lisa A. Beck, a dermatologist at the University of Rochester. But finding the most helpful products may require trial and error.

For example, my son tried several steroids before finding that mometasone furoate, the generic version of Elocon, is most effective for him. He has also used coal tar-based shampoo, like Neutrogena T/Gel, for occasional eczema on his scalp.

In selecting a moisturizer (often called an emollient), choose a product that contains no scent, which itself can be a skin irritant.

An acquaintance who suffered for years with widespread eczema finally found relief last year when her doctor suggested she try taking a nonsedatingantihistamine, like loratadine (Claritin), fexofenadine (Allegra) or cetirizine (Zyrtec).

Sweat can trigger an outbreak, so it is best to shower as soon as possible after a sweat-inducing activity. Stress can provoke flare-ups in some people with eczema, so measures to reduce stress may be helpful.

Food allergies show up as eczema in some patients. Eliminating one potential culprit at a time, like dairy products, eggs or nuts, may reveal an eczema-inducer.

Some people develop a form of eczema that results from skin contact with an irritant, not unlike a reaction to poison ivy. Contact eczema is often an occupational disease stemming from exposure to detergents, for example, or various cleaning agents or wet cement. The condition may show up only after the skin is exposed to sunlight. People with eczema on their hands are usually advised to wear cotton-lined waterproof gloves when washing dishes or working with irritating substances.

The Two Types of Bipolar Disorder

Published by:

The DSM-IV (the diagnostic Bible) divides bipolar disorder into two types, rather unimaginatively labeled bipolar I and bipolar II. “Raging” and “Swinging” are far more apt:

Bipolar I

Raging bipolar (I) is characterized by at least one full-blown manic episode lasting at least one week or any duration if hospitalization is required. This may include inflated self-esteem or grandiosity, decreased need for sleep, being more talkative than usual, flight of ideas, distractibility, increase in goal-oriented activity and excessive involvement in risky activities.

The symptoms are severe enough to disrupt the patient’s ability to work and socialize, and may require hospitalization to prevent harm to themselves or others. The patient may lose touch with reality to the point of being psychotic.

The other option for raging bipolar is at least one “mixed” episode on the part of the patient. The DSM-IV is uncharacteristically vague as to what constitutes mixed, an accurate reflection of the confusion within the psychiatric profession. More tellingly, a mixed episode is almost impossible to explain to the public. One is literally “up” and “down” at the same time.

The pioneering German psychiatrist Emil Kraepelin around the turn of the twentieth century divided mania into four classes, including hypomania, acute mania, delusional or psychotic mania, and depressive or anxious mania (ie mixed). Researchers at Duke University, following a study of 327 bipolar inpatients, have refined this to five categories:

  1. Pure Type 1 (20.5 percent of sample) resembles Kraepelin’s hypomania, with euphoric mood, humor, grandiosity, decreased sleep, psychomotor acceleration and hypersexuality. Absent was aggression and paranoia, with low irritability.
  2. Pure Type 2 (24.5 of sample), by contrast, is a very severe form of classic mania, similar to Kraepelin’s acute mania with prominent euphoria, irritability, volatility, sexual drive, grandiosity and high levels of psychosis, paranoia, and aggression.
  3. Group 3 (18 percent) had high ratings of psychosis, paranoia, delusional grandiosity and delusional lack of insight; but, lower levels of psychomotor and hedonic activation than the first two types. Resembling Kraepelin’s delusional mania, patients also had low ratings of dysphoria.
  4. Group 4 (21.4 percent) had the highest ratings of dysphoria and the lowest of hedonic activation. Corresponding with Kraepelin’s depressive or anxious mania, these patients were marked by prominent depressed mood, anxiety, suicidal ideation and feelings of guilt, along with high levels of irritability, aggression, psychosis and paranoid thinking.
  5. Group 5 patients (15.6 percent) also had notable dysphoric features (though not of suicidality or guilt) as well as Type 2 euphoria. Though this category was not formalized by Kraepelin, he acknowledged that “the doctrine of mixed states is … too incomplete for a more thorough characterization …”

The study notes that while Groups 4 and 5 comprised 37 percent of all manic episodes in their sample, only 13 percent of the subjects met DSM criteria for a mixed bipolar episode; and of these, 86 percent fell into Group 4, leading the authors to conclude that the DSM criteria for a mixed episode is too restrictive.

Different manias often demand different medications. Lithium, for example, is effective for classic mania while Depakote is the treatment of choice for mixed mania.

The next DSM is likely to expand on mania. In a grand rounds lecture delivered at UCLA in March 2003, Susan McElroy MD of the University of Cincinnati outlined her four “domains” of mania, namely:

As well as the “classic” DSM-IV symptoms (eg euphoria and grandiosity), there are also “psychotic” symptoms, with “all the psychotic symptoms in schizophrenia also in mania.” Then there is “negative mood and behavior,” including depression, anxiety, irritability, violence, or suicide. Finally, there are “cognitive symptoms,” such as racing thoughts, distractibility, disorganization, and inattentiveness. Unfortunately, “if you have thought disorder problems, you get all sorts of points for schizophrenia, but not for mania unless there are racing thoughts and distractibility.”

Kay Jamison in Touched with Fire writes:

“The illness encompasses the extremes of human experience. Thinking can range from florid psychosis, or ‘madness,’ to patterns of unusually clear, fast, and creative associations, to retardation so profound that no meaningful activity can occur.”

The DSM-IV has given delusional or psychotic mania its own separate diagnosis as schizoaffective disorder – a sort of hybrid between bipolar disorder and schizophrenia, but this may be a completely artificial distinction. These days, psychiatrists are acknowledging psychotic features as part of the illness, and are finding the newer generation of antipsychotics such as Zyprexa effective in treating mania. As Terrance Ketter MD of Yale told the 2001 National Depressive and Manic Depressive Association Conference, it may be inappropriate to have a discrete cut between the two disorders when both may represent part of a spectrum.

At the 2003 Fifth International Conference on Bipolar Disorder, Gary Sachs MD of Harvard and principal investigator of the NIMH-funded STEP-BD reported that of the first 500 patients in the study, 52.8 percent of bipolar I patients and 46.1 percent of bipolar II patients had a co-occurring (comorbid) anxiety disorder. Dr. Sachs suggested that in light of these numbers, comorbid may be a misnomer, that anxiety could actually be a manifestation of bipolar. About 60 percent of bipolar patients with a current anxiety disorder had attempted suicide as opposed to 30 percent with no anxiety. Among those withPTSD, more than 70 percent had attempted suicide.

Depression is not a necessary component of raging bipolar, though it is strongly implied that what goes up must come down. The DSM-IV subdivides bipolar I into those presenting with a single manic episode with no past major depression, and those who have had a past major depression (corresponding to the DSM -IV for unipolar depression).

DEA Inflicts Harm on Chronic Pain Patients

Published by:

In an effort to curb opioid drug abuse and addiction, the Drug Enforcement Administration (DEA) has issued new rules that limit the accessibility of hydrocodone, putting chronic pain sufferers who rely on the drug in an impossible situation.


The DEA’s new restrictions come after the decision to relabel hydrocodone as a Schedule II drug, making it difficult for users with chronic pain to receive the medicine they need. The recent changes include the elimination of phone-in refills and a mandatory check-in with a doctor every 90 days for a refill.

Hydrocodone is one of the most widely used drugs to fight chronic pain in the United States, serving a consumer base of about 100 million people. Many who rely on hydrocodone suffer from debilitating chronic pain, which greatly disrupts and decreases their quality of life.

Pain advocates across the country were vocal when the DEA announced these changes: they would have unintended consequences that would hurt, rather than help, legitimate pain patients in need. I spoke with a former patient of mine to find out how she was affected by the up-schedule of hydrocodone. She lives two hours away from the doctor who currently helps manage her pain. For her, it’s a 4 hour round trip every 90-days to access the medication that has helped revive a semblance normalcy since her pain first surfaced when she was just 20 years old. What’s worse, she told me that now, more than ever, she has been made to feel like a criminal for seeking access to medicine that has been rightfully prescribed to her by her own doctor.

In attempting to decode how other patients have been affected by the DEA rule change, the National Fibromyalgia and Chronic Pain Association (NFMCPA) released a survey of assessing the first 100 days after the regulatory change. The results are scary:

·        88 percent of patients felt that the changes denied their rights to access pain medication

·        71 percent report being switched to less effective medications by their doctors, who are fearful of legal issues

·        52 percent felt an increase sense of stigma as a patient receiving hydrocodone

·        27 percent of patients even reported suicidal thoughts when unable to access their prescription.

Controlling the abuse and overuse of pain killing drugs is necessary to keep patients safe, but the importance of decreasing drug abuse does not outweigh the needs of millions of people who suffer from chronic and depleting pain. When patients who suffer from these excruciating conditions are denied access to medication, they often turn to alternative forms of relief such as black market drugs, creating a larger issue of abuse.

Solving the problem begins with communication among the medical community, to ensure patients have access to their necessary medicine and the ability to live the life they deserve.

The medical system’s purpose is to treat and work for the betterment of patients. When we work against the people we are set up to serve, we are doing a great disservice to our cause and the people who rely on us most.

Democratic Candidates Addressed The Heroin Crisis In The United States & It’s About Time

Published by:

Two years ago, The New York Times released a mini-doc about how a surge in heroin use had contributed to fatal overdoses in Maine. This is a crisis that has been spreading across New England — including to New Hampshire, where Saturday night’s Democratic debate took place — as well as nationwide. As a result, the Democratic candidates were asked to address the national heroin crisis, which is remarkable considering that it is rarely discussed while marijuana legalization remains the mainstream topic of choice. But the fact that this question was posed indicates just how drastic the situation is, and just how much is left to be done. As one of the debate moderators pointed out, a recent poll indicated that 48 percent of New Hampshire’s residents say they know someone affected by the heroin crisis.

Vermont Sen. Bernie Sanders was the first to respond to the question, and he mentioned that his own state was significantly affected by the crisis as well. Sanders has been advocating for the legalization and decriminalization of marijuana use for some time, and has demonstrated an understanding of the way in which the War on Drugs perpetuates systemic racism. But Sanders has also evidently given a great deal of thought to the heroin crisis, and in his response, he called for dramatic health care reform.

Well, for a start, this may seem like a radical idea, but I think we have got to tell the medical profession and doctors who are prescribing opiates and the pharmaceutical industry that they have got to start getting their act together, we cannot have this huge number of opiates out there throughout this country, where young people are taking them, getting hooked, and then going to heroin.


Sanders also slammed the health care system for forcing people to wait months at a time to get treatment for addiction, rather than having a variety of treatment options readily available for anyone who might need them. He explained that the root of the problem lies in how addiction is perceived.

We need to understand that addiction is a disease, not a criminal activity. And that means — and that means radically changing the way we deal with mental health and addiction issues.

Former Secretary of State Hillary Clinton, meanwhile, described her own engagement with the issue. She delivered a brief anecdote about a campaign trail visit to Keene, New Hampshire, where she was asked the very same question. Clinton was not as specific as Sanders in explaining the nature of the crisis, but she did talk about the need for more facilities to treat addiction, as well as for law enforcement to carry Naloxone, the antidote to opioid overdose.

Clinton went on to say that she has held town halls on this issue, and has laid out a five-point plan that would involve putting in $10 billion over 10 years to work with states on this crisis. While she evidently does have some concrete policy plans surrounding this issue, Clinton also used this as an opportunity to celebrate Boston Mayor Marty Walsh’s willingness to publicly grapple with his alcoholism.

And I was proud to get the endorsement of Mayor Walsh of Boston, who has made his struggle with alcoholism a real clarion call for action in this arena.


Former Maryland Gov. Martin O’Malley was the last to respond to the question, and he had a personal experience to share.

I actually know a great deal about this issue. And I have a dear friend, played music with him for years, remember when his — when he came home with his baby girl, and now she’s no longer with us, because of addiction and overdose. The last time in New Hampshire, I had to take a break shortly after landing and call home and comfort a friend whose mother had died of an overdose.

O’Malley described the heroin crisis as a public health challenge, and he said that during his term, he expanded drug treatment funding in Maryland — something he said he would do nationwide as president. His plan calls for a $12 billion federal investment in local partnerships that could intervene to prevent deaths from overdose. To make the point crystal clear, O’Malley posed a critical question:

What would we do if this were Ebola? How would we act?


Sanders was the only candidate of the three that did not propose a specific federal investment during the debate, but his approach also differs from those of the other two. While O’Malley and Clinton called for more facilities, programs, and funding, Sanders went one step further — at least in rhetoric — to slam the criminalization of addiction and call for easier access to mental health resources. O’Malley talked about intervention, while Sanders talked about the system itself; this is an important distinction to make between the two.

In New England and nationally, the heroin crisis has been rapidly getting worse. As the election season continues, it will be vital for the candidatesfrom both parties to not only think about this issue, but also to meet with those who are affected by heroin addiction and determine how they might best help meet their needs. To learn more about the heroin crisis in New England specifically, watch the video from The New York Times below.

Researchers Closer Now to HIV Vaccine Than Ever Before

Published by:

In a new report, researchers look back on the 30-year effort to develop an HIV vaccine.

HIV Vaccine

In a global pandemic, the medical community rises up to find a cure.

With viral diseases, that cure often takes the form of a vaccine. But with the human immunodeficiency virus (HIV), the quest for such a vaccine has been a 30-year journey.

In a new report published in Science, researchers from the National Institute of Allergy and Infectious Diseases (NIAID) took a look back at the past three decades of research and action into an HIV vaccine.

Although the acquired immune deficiency syndrome (AIDS) epidemic is often associated with the 1980s and early 1990s, AIDS and HIV are still very much a part of many lives in the United States and around the world.

A vaccine against HIV would help millions.

“Obviously, a vaccine for HIV is one of the most important goals that we have if we want to durably end the AIDS epidemic,” said report co-author Dr. Anthony Fauci, director of the NIAID. “I think we’re doing a very good job of decreasing death and infections, even in the absence of a vaccine.”

About 1.2 million Americans were living with HIV at the end of 2011, the most recent year the Centers for Disease Control and Prevention (CDC) has data for. Across the world, there were about 35 million people living with HIV in 2013.

 “A vaccine, as with all viral diseases, will really be the nail in the coffin for HIV,” Fauci said.

The medical and research community isn’t there yet, but it’s getting close, he added.

Female suicide bombers kill dozens in Nigeria mosque attack during dawn prayers

Published by:

MAIDUGURI, Nigeria — Two female suicide bombers killed at least 24 worshippers and wounded 23 in an attack during dawn prayers Wednesday on a mosque on the outskirts of the northeast Nigerian city of Maiduguri, officials said from the birthplace of Boko Haram.

People inspect a damaged mosque following a suicide bomb explosion in Maiduguri, Nigeria Wednesday.

One bomber blew up inside the mosque and the second waited outside to detonate as survivors tried to escape, said coordinator Abba Aji of the civilian self-defense Vigilante Group.

The toll rose when rescuers digging through rubble discovered five more injured people and recovered four more bodies, including the bombers, according to emergency official Mohammed Chullu.


Umar Usman said he escaped because he was late to worship. “We were just a few meters away from the mosque when a loud bang erupted and all we could see was dark smoke and bodies littered around,” he told The Associated Press.

A hospital official said 13 bodies already have been claimed for the speedy burials required by Muslim tradition.

The inside of a damaged mosque following the suicide bomb explosion in Maiduguri, where female suicide bombers killed at least 24 worshippers and wounded 18 in the Wednesday attack.AP PHOTO/AP

The inside of a damaged mosque following the suicide bomb explosion in Maiduguri, where female suicide bombers killed at least 24 worshippers and wounded 18 in the Wednesday attack.

The Umarari mosque is on the outskirts of Maiduguri, the city that is the military command center of the war against Boko Haram Islamic insurgents. Reports that Umarari is a Boko Haram stronghold were incorrect, officials said.

Several suicide bombers have exploded in recent months at roadblocks leading into the city, indicating success in preventing attackers from reaching crowded areas.

It is the first attack on Maiduguri since Dec. 28, when rocket-propelled grenades and multiple suicide bombers killed 50 people including refugees from the war.

The military said dozens of emaciated extremists surrendered this month, indicating success in cutting supply routes, including from neighboring countries to which the insurgency has spread.

Nigeria’s President Muhammadu Buhari has claimed that the military has forced Boko Haram out of all towns. But the general in charge of U.S. Africa Command said they still hold “significant” territory and northeastern officials said that includes three border towns.

Moby Opens Vegan Restaurant, Donates All Profits to Purrr-fect Cause

Published by:

You might know Moby from his cool electronica music, or his DJ and recording work that has earned about $30 million, but did you know about his new vegan restaurant in Los Angeles that is giving all its profits to animal charities?


After opening the Little Pine bistro in November, the music tycoon announced that every nickel they made would be donated to organizations such as The Humane Society, Mercy for Animals, Farm Sanctuary, Sea Shepherd, and PETA.

MORE: DiCaprio Donates $15 Mil to Help Save the Planet and Animals On It

“Opening Little Pine was never meant to be a conventional entrepreneurial endeavor,” Moby explains in a press release. “I want it to represent veganism in a really positive light, and also help to support the animal welfare organizations who do such remarkable work.”

The hip space located at 2870 Rowena Avenue features Mediterranean, plant-based cuisine & woodsy-chic design that reflects the celebrity’s interest in architecture.

RELATED: New Organic Drive-Thru From Amy’s Offers Vegan Fries With Your Non-GMO Burger

“I can write about organic food and veganism and architecture & design, but it’s a lot more compelling and interesting to open a restaurant and show actual, physical examples of organic food, community, veganism, and architecture & design,” says Moby on the website. “Blogs and instagram are great, but a picture of food will never replace an actual, beautiful plate of food served in a beautiful space.”

6 Things Your Doctor Won’t Tell You About Vitiligo

Published by:

1. You probably have a leaky gut and low stomach acid

Leaky gut, A.K.A. intestinal permeability, is the microscopic loss of the integrity of your intestinal lining. In other words, it’s teeny tiny holes in the lining of your intestine.

Poor diet (excessive sugar intake or alcohol consumption), lack of good bacteria, antibiotics and medications (including OTC meds such as aspirin or ibuprofen), chronic inflammation, and food sensitivities.

2. You likely have thyroid and adrenal dysfunction of some sort

Hashimotos is often seen along with vitiligo, as this study shows. It mentions that there is “a significant association between vitiligo and thyroid autoimmunity, and that tests to detect thyroid autoantibodies are relevant in patients with vitiligo.

If you have vitiligo, especially vitiligo that is active, you may want to consider getting your thyroid and adrenal function checked. Vitiligo is often a sign that other things are wrong inside of your body.

An endocrinologist can run a FULL thyroid panel for you…NOT JUST TSH. This is very important. A full thyroid panel will include TSH, T3 and T4 levels, TPO antibodies (crucial for detecting Hashimotos Thyroiditis).

A 24-hour urine cortisol test or a hair mineral analysis test are the best ways to get your adrenal function checked – I did both and they both revealed severe adrenal fatigue. I think you can also get a blood test as well.

3. You could have a copper/zinc imbalance

Many people are under the impression that because low copper levels are implicated in vitiligo then this must mean they need to take more copper. However, most people (women especially) are copper toxic and some also have copper bio-unavailability, which means the body is unable to use the copper for some reason. Taking more copper will aggravate this problem.

On the flip side, most people are zinc deficient. This article mentions vitiligo as one of the symptoms of zinc deficiency:

These include stretch marks on the skin, varicose veins, and, in fact, most cases of acne, dermatitis, eczema, psoriasis, boils, vitiligo, skin infections and many others.  They also often include white spots on the fingernails, although there are a few other causes of this symptom.

Zinc is a strong copper antagonist – which means that it prevents the body from accumulating too much copper. Many vegetarians are copper toxic because meat is naturally high in zinc and helps prevent the accumulation of copper in the body. If you have vitiligo, it may be helpful to evaluate your diet and see if you may benefit from taking a zinc supplement.

In addition to controlling copper levels, zinc appears to be important in preventing and treating vitiligo by inhibiting free radicals, encouraging repigmentation, and preventing immunity related cells that result in toxin accumulation, altered cellular environment and infection.

4. You are gluten intolerant, and possibly have celiac

Gluten is a dangerous food for those with vitiligo, celiac, and hashimotos thyroiditis. Gluten is very damaging to the gut and its molecular structure actually resembles the thyroid gland – which causes your body to become confused and attack the thyroid gland.

So, if you have vitiligo you may want to avoid gluten altogether as it can be very risky, to say the least.

5. Changing your diet can help you stop your vitiligo from spreading and can help repigment stable vitiligo.

There’s no specific “diet” for vitiligo – and many people will tell you that diet is worthless for treating vitiligo. However, based on the research that I have done, I have come to realize that diet plays a very important role in treating ANY autoimmune disorder, including vitiligo.

The reason for this is simple:

Proper immune system function is heavily dependent on a healthy diet, full of vitamins and minerals. Also, autoimmune disorders are largely due to inflammation in the body, which is diet related.

The most important vitamins for vitiligo are the B complex vitamins, especially B-12, B-6, and folate (not folic acid).

It’s best to take the methylated forms of B-12 and folate. The B-12 should be in the form of methylcobalamin (not cyanocobalamin), and folate should say 5-MTHF on the label. This means they are already in a form that your body can use immediately. Your body has to convert folic acid and cyanocobalamin into usable forms.

The problem is that it has been discovered that many people have an MTHFR mutationthat prevents folic acid from being converted into MTHFR-the usable form of folate. I found out that I have an MTRR A66G mutation, which means that I have poor ability to methylate B-12, so it’s important for me to take methylcobalamin.

6. It’s not hopeless.

Doctors will always tell you there is no cure, because this is what they believe…and many of them have little to no experience treating vitiligo, so they really don’t know what else to tell you.

Remember, docs don’t know everything, so when they say negative or discouraging things, just respect their opinion and move on to a more open minded doctor that is willing to work with you. Don’t be disheartened, there are lots of things you can do to help yourself.

Sure, you won’t reverse your vitiligo overnight, but it can be done. It just takes a lot of determination and belief that it will happen

Has Yale University finally found a cure for vitiligo?

Published by:

A common arthritis drug which is already prescribed on the NHS appears to stop the loss or pigmentation caused by vitiligo

The skin condition vitiligo could be cured with a common arthritis drug already being prescribed on the NHS, scientists at Yale believe.

The condition, which leads to the loss of pigmentation on the skin, affects around 650,000 people in Britain including presenter Richard Hammond, comedian Graham Norton and Kara Tointon, the actress.

But Yale University has shown that the drug tofacitinib, which is currently prescribed for rheumatoid arthritis, can clear up the problem.

A 53-year-old patient with prominent white spots covering her face, hands, and body was given the drug for five months and found the condition virtually disappeared. Only a few spots remained on her body, and all had gone from her face and hands.

“While it’s one case, we anticipated the successful treatment of this patient based on our current understanding of the disease and how the drug works,” said Dr Brett King, assistant professor of dermatology and principal investigator of the research at Yale University, US.

“It’s a first, and it could revolutionize treatment of an awful disease.

“This may be a huge step forward in the treatment of patients with this condition.”

A 53-year-old woman before and after five months of treatment Credit: Dr Brett King

Dr King is now hoping to begin a wider clinical trial into the effectiveness of using tofacitinib or a similar medicine, ruxolitinib, for the treatment of vitiligo.

Vitiligo is a common, psychologically devastating condition that causes skin to lose its pigmentation and current treatments, such as steroid creams and light therapy, are only partially effective in reverse the problem.

Last year Dr King showed that tofacitinib could be used to treat alopecia which is caused when the body’s own immune system becomes confused and starts to attack hair follicles. However tofacitinib stops the chemical pathway that triggers that immune response allowing hair to grow back.

Because vitiligo is caused by a similar immune response, which destroys pigment-forming cells known as melanocytes, researchers speculated that the same treatment should work to restore colour.

“This case exemplifies the ways by which advances in basic science can guide treatment decisions and ultimately benefit patients,” added Dr King.

“As we better understand the mechanisms of different diseases, targeted therapy becomes possible, and existing medications can be repurposed and/or new medications created for diseases with limited, if any, treatment options.”

The most well-known sufferer of the condition was Michael Jackson, but actor Jon Hamm has also spoken about developing the skin condition due to the stress of filming Mad Men.

Professor David Gawkrodger, a spokesman for the British Skin Foundation Spokesperson, said the research was ‘promising’ but warned it was too soon for patients to be demanding Tofacitinib from their doctors.

“In vitiligo immune and cell growth factors are involved hence it is not surprising that the vitiligo in the patient described has improved.

“The janus kinase inhibitor group of drugs are still being evaluated and may have significant side-effects so, although this is a promising observation therapeutically, that may also tell us something about the causation of vitiligo, it is too soon for patient to demand these drugs from their dermatologists.

“The drugs may well be a pointer to how vitiligo will be managed in the future, but further evaluation by dermatologists, the pharmaceutical industry and regulators is needed.”

World’s first dengue vaccine could be good news for Costa Rica, Central America

Published by:

December 23rd, 2015 (VOA) The Philippines has granted approval for the sales of a new dengue vaccine, following Mexico as the first two countries to allow a treatment that could prevent the flu-like illness that threatens half the world’s population, including Costa Rica, where an average 3,500 cases are confirmed annually in country of 4.8 million where the mosquito-transmitted virus is common.

The recombinant, live, attenuated tetravalent vaccine (CYD-TDV) is the first to hit the market targeting dengue, which is transmitted by the bite of a mosquito and can cause crippling fevers, along with muscle and joint pain.

Dengvaxia, as it has been named by its maker France-based Sanofi Pasteur, comes at a time when a “safe and effective vaccine is urgently needed,” according to the World Health Organization.

While Costa Rican officials have not indicated when – or if – the new vaccine may be made available here, it “has demonstrated clinical efficacy and a good safety profile,” according to medical researchers at Chulalongkorn University in Bangkok in a paper recently published in the Southeast Asia Journal of Tropical Medicine and Public Health.

Sanofi Pasteur said the vaccine has been demonstrated effective against all four dengue virus types.

“The vaccine actually is given in three dose schedules with a six-month interval. It is being given (to people) from nine years of age up to 45 years of age. This is the age range wherein most of the dengue cases are being reported, particularly in endemic countries here in Asia,” according to Dr. Joselito Santa Ana, head of dengue vaccine operations in the region for Sanofi Pasteur.

Hopes for dramatic reductions by 2020

The vaccine’s maker is hailing it as an important tool to reach the World Health Organization’s objective on dengue, a potentially deadly disease for which children are at particular risk.

“Together with vector control it will form an integrated approach in reducing dengue mortality by 50 percent and reducing the dengue morbidity by more than 25 percent by 2020,” Dr. Santa Ana, speaking from Manila, told VOA on Wednesday.

Clinical tests were carried out on 40,000 people from 15 countries.

Some two-thirds of those over the age of nine were deemed to be protected and the vaccine was found to be 93 percent effective against the most severe form of disease, dengue hemorrhagic fever.

While being hailed as a breakthrough, there is concern about vaccinating younger children and an unanswered question about the new vaccine’s long-term efficacy.

A higher incidence of hospitalization in the third year after vaccination among children younger than nine years of age naturally infected with dengue raises a “critical question” whether this is a short-term or long-term phenomenon” noted an editorial in the September 24 edition of the New England Journal of Medicine which suggested booster doses of the vaccine might reduce this risk.

The journal praised the trials as “superbly conducted” while noting, due to traditional concerns about partial, waning immunities the “bumpy road to a vaccine-based solution for dengue continues.”

“As with all new vaccines, it is unknown how long the measured protection against dengue will last,” the WHO also cautioned in November, 2014.

Pharmaceutical companies in Japan, Britain and the United States are also developing dengue vaccines.

Vaccine price still unclear

Another question mark is cost.

Newly developed pharmaceutical products are frequently very expensive when they initially go on sale and not affordable for many patients.

But Dr. Santa Ana said the maker of the dengue vaccine wants to maximize the access to all populations, while acknowledging the market price of Dengvaxia has not yet been established.

“We are committed to offering a fair and equitable price for the vaccine that is sustainable both for the company and the government whose going to implement it in the public program,” he said.

The CYD-TDV vaccine, in development for 25 years, has been submitted for licensing in 18 other countries in Asia and Latin America where dengue is endemic.

India may exempt Dengvaxia from large-scale clinical trials in order to expedite clinical trials, the Economic Times reported Tuesday, quoting health industry sources.

More than 90,000 dengue cases with 181 deaths were reported in India through the end of November for this year.

Dengue was traditionally a disease primarily confined to the tropics. Now, about half of the world’s population is considered at risk due to urbanization, jet travel and climate change.

Dengue cases have soared 30-fold in the last half century, according to the WHO, with an estimated 400 million people now infected annually.

The first doses of Dengvaxia, which utilizes a yellow fever virus with substitutions of two genes encoding dengue proteins, are already being produced in France where manufacturing of 100 million doses annually are planned, according to Sanofi Pasteur.